Senate bill pursues midwife restrictions

Panel passes banon home births forsome pregnancies

Jacy Brooks, with her 18-month-old child, Ladlie, attends the Senate Health and Human Services Committee hearing on Wednesday with other mothers and home-birth-rights advocates to show support for midwives.

Arizona midwives’ successful bid to allow more women to give birth at home may be overturned before it’s even implemented.

Licensed midwives, their clients and state health officials worked for more than a year to update state regulations. Starting in July, some women who had previously given birth via Caesarean section or whose baby was in a breach position prior to birth were to be allowed to give birth at home with the help of a midwife.

But Sen. Kelli Ward, R-Lake Havasu City and a physician, has introduced legislation banning licensed midwives from overseeing the deliveries of women who have had C-sections. Senate Bill 1157 also would forbid licensed midwives from overseeing the deliveries of women pregnant with multiple babies or whose babies are breach.

The bill has an emergency clause, meaning it would go into effect immediately upon becoming law instead of the standard three months later.

Ward said she has concerns about the safety of allowing higher-risk deliveries at home.

“I’m a pro-life legislator. I see the mom and the baby as two separate entities,” Ward said. “I would love to preserve the choice of the mother for their home birth, but that child also needs to have a choice ... the choice not to die.”

The Senate Health and Human Services Committee passed the bill Wednesday. It now needs a vote of the full Senate before moving to the House. Because it’s an emergency provision, it requires the support of two-thirds of the House and Senate.

Arizona is one of 27 states to allow midwives to deliver babies. Midwives handle about 1 percent of births in Arizona.

During Wednesday’s committee hearing, Ward said she introduced the bill because of concern from the medical community.

“Infants born at home have more than a three-time risk of dying than infants born in a hospital,” she said.

She said under the bill, certified nurse midwives, who must have a master’s degree, would still be able to deliver these mothers’ babies. It would just restrict midwives licensed through the Arizona Department of Heath Services.

More than 150 people signed in against the bill at the hearing; 29 signed in support of the bill.

Tory Anderson, who spoke on behalf of the Rights for Home Birth consumer group, gave the health committee a petition signed by 1,500 people supporting allowing licensed midwives to serve those women.

“This bill will limit a mother’s personal heath-care choices,” she said. “Women and mothers are smart, informed and educated. We have a right to do our own research and make our own choices for our births.”

Dr. Nathan Lepp, a local neonatologist, testified in support of the bill, saying studies indicate there is a higher risk for babies born at home to have lower Apgar test scores — a standard medical exam to assess the health of newborns — and a higher risk of seizures shortly after birth.

“I appreciate women’s rights, but we also have to look at the interest of the child,” he said. “There is a long-term potential for neurological dysfunction.”

Elizabeth Morton, who gave birth to her son with the help of a midwife, said she knew the risks of home birth when she made her decision, but argued there are also risks with giving birth in a hospital. She said the state’s current rules do have restrictions to help mitigate those risks, including requiring that the woman have had only one C-section. The woman also must live within 25 miles of a hospital.

Marinah Farrell, a local midwife and president of the Midwives Alliance of North America, said that while consumers nationwide are asking for more access to midwives, state legislatures have begun trying to put more limits on them. She said statistics do not show hospital births are significantly safer than home births.

“A planned home birth for low-risk women with a licensed, credentialed midwife is proving to be safe,” she said.

The committee’s four Republicans supported the bill; the three Democrats opposed it.

“We have to ensure public health and safety is complete,” said Sen. Kimberly Yee, R-Phoenix.

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